Brief Summary The goal of this clinical trial is to evaluate the impact of a disease-specific, individualized diet on the nutritional status and functional abilities of Duchenne muscular dystrophy (DMD) patients. The study will focus on children aged 4-8 years residing in Ankara, Turkey. Key questions the investigators aim to answer: Can a tailored dietary intervention improve the nutritional status of DMD patients? Does a specialized diet positively impact the functional abilities of DMD patients, as measured by the North Star Ambulation Assessment (NSAA)? Participants will undergo a comprehensive nutritional assessment, including anthropometric measurements, and will receive individualized dietary counseling. The intervention will focus on optimizing energy, protein, calcium, and fluid intake, as well as addressing the potential side effects of corticosteroid therapy. The primary outcome measure will be changes in nutritional status, as assessed by anthropometric measurements. Secondary outcome measures will include changes in functional abilities as measured by the NSAA and quality of life assessments.
Study Objective This study aims to investigate the efficacy of a disease-specific, individualized dietary intervention in improving the nutritional status and functional abilities of Duchenne Muscular Dystrophy (DMD) patients aged 4-8 years residing in Ankara, Turkey. Study Design This is a prospective, interventional study. Intervention A 12-week individualized dietary intervention will be implemented for each participant. The intervention will focus on: * Energy Intake: Caloric needs will be calculated based on the patient's age, weight, and activity level, taking into account the potential impact of corticosteroid therapy on energy expenditure. * Protein Intake: Protein requirements will be met through a balanced diet, aiming to optimize muscle protein synthesis. * Calcium and Vitamin D Intake: Adequate intake of these nutrients will be emphasized to support bone health and prevent osteoporosis. * Fluid Intake: Fluid intake will be monitored to prevent dehydration and constipation. * Carbohydrate Intake: A low-glycemic index diet will be recommended to manage blood glucose levels and insulin resistance, especially in patients on corticosteroid therapy. * Sodium Intake: Sodium intake will be restricted to minimize fluid retention and hypertension. Outcome Measures Changes in anthropometric measurements (body weight, height, BMI, skinfold measurements) Changes in functional abilities as assessed by the North Star Ambulation Assessment (NSAA) Changes in functional abilities as assessed by handgrip strenght Changes in micro and micro nutrient intake as assessed by three-day food consumption record Data Collection Data will be collected through face-to-face interviews with parents or primary caregivers and patients with DMD. After the first interview, a second interview will be conducted 12 weeks after the personalized diet has been planned. Baseline Assessment: * Demographic information * Medical history * Nutritional assessment (anthropometric measurements, dietary intake assessment) * Functional assessment (NSAA) Follow-up Assessments: * Anthropometric measurements * Functional assessment (NSAA) * Dietary intake assessment Data Analysis Statistical analysis will be performed using appropriate statistical software. Descriptive statistics will be used to summarize the baseline characteristics of the participants. Parametric or non-parametric tests will be used to compare pre- and post-intervention outcomes, as appropriate. Ethical Considerations The study will be conducted in accordance with the Declaration of Helsinki and approved by the local ethics committee. Informed consent will be obtained from the parents or legal guardians of the participants. By addressing the specific nutritional needs of DMD patients, this study aims to improve their overall health and quality of life.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
9
* Energy Intake: Caloric needs will be calculated based on the patient's age, weight, and activity level, taking into account the potential impact of corticosteroid therapy on energy expenditure. * Protein Intake: Protein requirements will be met through a balanced diet, aiming to optimize muscle protein synthesis. * Calcium and Vitamin D Intake: Adequate intake of these nutrients will be emphasized to support bone health and prevent osteoporosis. * Fluid Intake: Fluid intake will be monitored to prevent dehydration and constipation. * Carbohydrate Intake: A low-glycemic index diet will be recommended to manage blood glucose levels and insulin resistance, especially in patients on corticosteroid therapy. * Sodium Intake: Sodium intake will be restricted to minimize fluid retention and hypertension.
DMD Aileleri Derneği
Ankara, Çankaya, Turkey (Türkiye)
Anthropometric measurements
Changes in body weight (kg). Body weight will be measured with an electronic scale sensitive to 0.1 kilograms.
Time frame: From enrollment to the end of diet at 12 weeks
Anthropometric measurements
Changes in skinfold thickness (triceps, biceps, subscapular, and suprailiac) (in millimeters) Skinfold thickness will be compared to the World Health Organization's percentile and Z score charts to determine adequacy, deficiency, or excess.
Time frame: From enrollment to the end of diet at 12 weeks
Anthropometric measurements
Changes in height (cm). Height is measured with the individual standing upright and the head in the Frankfurt plane (the orbitale point and tragion point are set to be on the horizontal plane), while the vertical distance from the ground to the vertex, which is the highest point of the head, will be measured with a tape measure on a fixed plane.
Time frame: From enrollment to the end of diet at 12 weeks
Anthropometric measurements
Changes in Body Mass Index (BMI)(kg/m²). BMI will be obtained by dividing the particioant's body weight in kg by the square of the height in meters. Body mass index will be evaluated with the World Health Organization's percentile and Z score charts.
Time frame: From enrollment to the end of diet at 12 weeks
Functional Ability
Changes in the North Star Ambulation Assessment (NSAA) score meausered by a specialist physiotherapist. The total score varies between 0-34. A higher score indicates better ambulation and motor function.
Time frame: From enrollment to the end of diet at 12 weeks
Functional Ability
Changes in hand grip strength measured by hand dynamometry (in kilograms)
Time frame: From enrollment to the end of diet at 12 weeks
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